Intestinal location

If an ingested lead object is seen below the gastro-duodenal junction on abdominal X-ray, it is safe to monitor the patient for up to 14 days since the time of ingestion and wait for the object to pass. During that time, advise the patient to:

• consume a high-fibre-diet
• use a laxative
• return for a repeat abdominal X-ray every 7 days.

If the object is not moving on repeat X-rays, or the object has not passed and it has been more than 14 days since the time of ingestion, seek a surgical opinion for endoscopic or surgical removal of the object. Consult a clinical toxicologist about whether to measure the whole blood lead concentration.